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Background: Sports and recreational accidents involving critical areas of the body occur commonly in the general population. Reports on their demographics and recommendations for screening procedures are, however, few. Purpose: To assess injuries of the craniofacial area, spine, and torso resulting from sports and recreational accidents with multidetector computed tomography (MDCT) as primary imaging method in a Level I trauma center. Material and Methods: All emergency room CT requests over a time span of 105 months were reviewed retrospectively for trauma mechanism and injury. Patients were identified using an electronic picture archiving and communications system (PACS), and MDCT studies interpreted by two radiologists independently. Results: Of a total of 5898 patients, 492 patients (301 boys/men, 191 girls/women, age range 2-76 years, mean 33.5 years, median 29.5 years) with sports or recreational accidents emerged. A total of 102 traumatic findings were diagnosed, thereof 72 (71%) serious. The three most commonly encountered serious injuries were intracranial injury, fractures of facial bones, and vertebral injuries. The three most common injury mechanisms were bicycling, horseback riding, and team ball sports. Patients from recreational activities were on average significantly younger (29.2 years) than those from sports accidents (36.9 years; P < 0.001). Only age groups <21 years and 41-50 years differed in injury severity from the other age groups (P = 0.004 and P = 0.063, respectively). Of all trauma mechanisms, only bicycling had a significantly increased risk of injury (P < 0.001). Conclusion: Injuries in sports and recreational accidents presented with an overall incidence of 21%, of which 71% are serious. The most common mechanisms of injury were bicycling, horseback riding, and team ball sports. The largest incidence of serious injury involved bicycling. Because of the high probability of a serious injury and the high energies that are often involved in these accidents, we recommend ruling out of internal injury by MDCT as the primary imaging modality. [ABSTRACT FROM AUTHOR]

Background: Patellar dislocation is frequently associated with bony fragments that are difficult to see on radiographs. MRI or MDCT are often used to rule out or characterize these bony fragments. Purpose: To assess the use of MDCT for locating bony fragments and donor sites in patients with acute patellar dislocation, and to test whether sizes and quantity of bony fragments differ between first-time dislocations and recurrent dislocations. Material and Methods: Retrospective data from two hospitals during a 96-month period were collected, and a total of 46 patients (mean age 27 years, range 9-69 years) that had sustained an acute patellar dislocation (22 first-time, 24 recurrent) were identified. Size, location and donor site of bony fragments were evaluated on MDCT images. Surgical correlation was available for 22 of 46 patients. Results: On MDCT images, the likely donor site could be identified in 62 of 71 (87%) bony fragments. Of the bony fragments that were seen on MDCT images, 40 of 68 (59%) were not seen on AP and lateral views of the conventional radiographs. There was no significant difference in size of bony fragments between first-time or recurrent dislocators (p=0.77). The average number of bony fragments were 2.1 and 1.0 in first-time and recurrent dislocators, respectively. The location and donor site of bony fragments was similar between two patients groups. Conclusion: MDCT is a suitable imaging method to locate bony fragments and donor sites. The number of bony fragments seems to be higher in first-time dislocators than recurrent dislocators, otherwise findings between the two patient groups were similar. [ABSTRACT FROM AUTHOR]

The aim of this study is to assess multidetector computed tomography (MDCT) findings of facial trauma due to a falling accident. Using picture-archiving and communications system, we retrieved all MDCT requests for suspected facial injury during a 62-month period. Images were interpreted by two researchers. Five hundred patients met the inclusion criteria and 329 (66%) had a total of 515 fractures. Falls on stairs were seen in 109 (22%) patients and slips or trips in 391 (78%). The corresponding number of fractures was 169 (33%) and 346 (67%). Males (N = 241) had more fractures than females (N = 259), 327 vs. 188, respectively. The zygomatic complex was the most common fracture, seen in 40% of patients suffering a fracture. Twenty patients (4%) had fractures involving the sinus walls without paranasal sinus effusions. Facial fractures due to falls are common. The zygomatic complex is the most common fracture. A clear sinus sign may be less reliable than previously thought. [ABSTRACT FROM AUTHOR]

An open-configuration magnetic resonance imaging scanner was used to document patellar tracking abnormalities in 11 anterior cruciate ligament-injured knees. The contralateral normal knees were used as controls. Images were obtained with the quadriceps muscles at rest (knee flexion at 40 degrees, 25 degrees, and 10 degrees) and with the quadriceps muscles contracted (knee flexion at 40 degrees and 25 degrees). When the quadriceps muscles were at rest there were no differences in patellar alignment between the anterior cruciate ligament-injured knees and the contralateral normal knees. When the quadriceps muscles were maximally contracted at 40 degrees of flexion, the patellae of the anterior cruciate ligament-injured knees tilted laterally 3.6 degrees relative to the resting state. When the quadriceps muscles were contracted at 25 degrees of flexion, the patellae of the anterior cruciate ligament-injured knees tilted laterally approximately 4 degrees relative to the resting state. Quadriceps-active lateral patellar tilt at 25 degrees of flexion was greater in the anterior cruciate ligament-injured knees than in the contralateral normal knees, and it correlated with instrumented measurements of anterior tibial translation. Dynamic lateral patellar tilt during open kinetic chain exercises and during other activities that produce anterior tibial translation may contribute to extensor mechanism dysfunction in the anterior cruciate ligament-injured knee. [ABSTRACT FROM AUTHOR]